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General NPI Number Information
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NPI Number | 1922341908
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Entity Type | Individual
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Provider Name | MRS. MADISON D ALCAZ
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Gender | Female
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Dates
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Enumeration Date | 03/28/2013
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Last Update Date | 03/28/2013
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Provider Practice Location Address
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Address Line | 5855 E BROADWAY BLVD SUITE 100, STUDIO 10
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City | TUCSON
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State | AZ
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Zip | 85711-3906
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Country | US
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Telephone | 520-270-8253
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Fax |
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Provider Business Mailing Address
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Address Line | 667 W CALLE TOLMO
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City | SAHUARITA
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State | AZ
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Zip | 85629-7820
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Country | US
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Telephone | 520-270-8253
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 3024988
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License Number State | AZ
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